In those murky years between the end of school and start of a career, the paths that young 20-somethings choose often determine whether they will be covered by health insurance or not.

Take Lawrence mother Janice Friedman and her two children - a son and a daughter, one on each coast.

Her son graduated from college, went to law school and then straight on to a law firm. He has had health insurance all his life.

The daughter, well, that's a different story.

The former art student weny years in her 20s without health insurance. Pre-existing conditions kept her from being covered between undergraduate and graduate school. And now even after earning her master's degree in museum studies, her salary isn't enough to cover health insurance and the rent.

During the times her daughter is without coverage, Friedman holds her breath, hoping nothing goes too wrong. For a mother who has a long history with cancer, it can be nerve-racking.

"It is really scary knowing my kids may not have the kind of insurance they need over the years to identify the problems that may be passed on to them," Friedman said.

Two proposals

This month, the Kansas Health Policy Authority Board released a 21-point plan directed at reforming the state's health care system. Among their recommendations were two targeted toward those between the ages of 19 and 25.

¢ Allow parents to keep children on their family insurance plan through age 25.

¢ Develop an insurance plan for young adults with limited benefits and lower premiums.

The two proposals could pick up more than 15,000 of Kansas' 300,000 uninsured, the health policy authority estimates.

In Kansas, about one in five people between the ages of 19 and 24 do not have health insurance. It's a higher percentage than any other age group.

The health policy authority board's recommendations are intended for a demographic that still depends on their parents for support, have low incomes and are unaware of the importance of health insurance, the authority's policy director Barb Langner said.

"They don't realize how much liability they are taking on if a serious accident or illness occurs," Langner said. "They'll incur quite a bit of debt."

Going without

Last legislative session, state Sen. Vicki Schmidt, R-Topeka, proposed a bill that would have kept children on their parents' insurance longer. It went nowhere.

The pharmacist and mother of a soon-to-graduate college student has heard from plenty of concerned parents. Many of them are her friends.

"My goal is to get more people in that age group insured," Schmidt said.

Arron Atchison, a 21-year-old barista at Lawrence's The Java Break, said if he could stay on his father's insurance, he would.

Atchison can't afford health insurance. When he needs medical attention, he pays the full retail price at health clinics. Although he saves money forgoing insurance, Atchison is aware that it's a practice that could cost him someday.

"If I get hit by a car, I am going to be in debt for the rest of my life," he said.

Many of the students who use Kansas University's Watkins Memorial Health Center are still on their parents' insurance plans, have purchased the school's policy or are covered under teaching positions and other jobs. However, some go uninsured.

"If they are going to skip something, unfortunately, it is going to be health insurance," said Diana Malott, assistant director of KU's student health services.

At Health Care Access, one of two clinics in Lawrence geared toward the uninsured and low-income population, executive director Nikki King said the 19 to 25 age group makes up a small part of their patients. The age segment tends to be healthier than the more typical 35-and-over patient. But there is a risk.

"That is the scary point, if something chronic does crop up, there is going to be a significant expense. If there is an accident, there is a significant expense," King said. "That is kind of the whole point of insurance, those great big 'what ifs' out there. But, being young and healthy, they usually don't think like that."

Time to grow up

Not everyone agrees that children should stay on their parents' health insurance plan until age 25.

State Sen. Jim Barnett, R-Emporia, said 20-somethings should learn early the value of health insurance. The same age group doesn't hesitate to pay for car insurance or homeowners insurance, he said.

"One of the drawbacks of staying on a parents' plan, it really delays the notion or idea that young people should be insured and they should be planning to take care of themselves," Barnett said.

Barnett also believes the change would put pressure on small businesses, who would then be forced to drop dependents from their insurance plans altogether.

Ken Daniel, owner of Midway Wholesale and with the Topeka Independent Business Association, agrees.

He doesn't think it is fair that he would have to cover his own 23-year-old employees and someone else's 23-year-old employee.

Even though the age group is a healthy one, Daniel said that one car accident, time in rehab for substance abuse or a severe illness could raise premiums for all his 117 workers.

And, he said, plans for less than $50 a month provide protection in case of rare, high-cost medical expenses.

"Half of them aren't going to use it. They don't see the value," Daniel said. "I don't think putting them on others' policies is the answer."

The cutoff needs to be drawn somewhere when it comes to dependents, said Bill Sneed, a Topeka attorney who represents insurance companies. Many insurance plans in Kansas drop children from plans at age 23.

Young adult plans

Barnett, Daniel and Sneed don't have qualms with the health policy authority's proposal to create an insurance plan for young adults. The insurance would cover catastrophic medical expenses and some health prevention and promotion areas as well, Langner said.

The health policy authority board stipulated that health insurance should be affordable - in other words, about 10 percent of the young adult's income. The idea is based off a program instituted this year in Massachusetts.

Sneed said that insurance companies would be willing to provide plans for the age group, but that trade-offs have to be made.

"The more things you load into policies, the more expansive it becomes," he said. "Whenever we have gone down this road - and this has been looked at at least two times in the years I have represented the industry - it is not what you cover, it is what you don't cover that causes consternation."

That is what worries Corrie Edwards, executive director of Kansas Health Consumer Coalition.

"It could be a bare bones plan with an outrageous deductible, with no mental health coverage, no prescription drugs, nothing to the plan," Edwards said.

In the case of Friedman's daughter, who has managed to make it through her 20s uninsured and with no major medical mishaps, the health policy authority board's recommendations would have helped.

But Friedman believes the proposals are little more than stop-gap measures.

"Students seem to be taking more time. Kids don't grow up as quickly as they once did. They are staying in school longer. Certainly extending (parents' coverage) for a few years is something that is helpful," Friedman said. "But it is just a small piece of the big problem."

Comments

National Health Insurance is the only answer for all. Veterans,college students,single parents as well as the rich and poor. Bring health care under one umbrella for efficiency. National Health Insurance means all contribute something to the expense of medical care....there is no absolute free ride. Tax dollars as it is provide approximately 64% of the cost of corporate healthcare which is a lot of people.

The bottom line is perhaps it will produce a more productive population.

These college students can buy health insurance for less than $100 a month. They are gambling that they will stay healthy because most of them are at the age where they are healthy. They don't worry as much about the ailments that older Americans do.

Wow, how un-american. I thought we all looked out for each other. It's OK Merril, I know that whatever I paid in Nationalized healthcare tax, it's going to be LESS than what I now pay for privatized health care. I don't mind paying for you, me, and everyone else.

"I suggest you and your kind quit having babies expecting others to take care of them."

And this one is right out of Mao's handbook! What gives dolly? are you a commie? I'm callin' homeland security.

Did you read the article? Does the phrase "pre-existing condition" ring a bell? When (if) you had children, were you sure you could provide health insurance, for their entire life, no questions asked, no matter their unexpected health needs?

Young adults can be in a very precarious position. Their parents' plans won't cover them. If they have a "condition", no one has to take them on at any price. And, legal or not, most employers offering insurance will figure out if you have a health history before offering you a job.

If you like how the government has handled Iraq and Hurricane Katrina, wait until it gets its hands on health care. You do not want an inefficient, bureaucratic, red tape-riddled government agency nannying you through one more aspect of life.

I guess I should have looked into my crystal ball for the major "curve balls" that life has thrown us when we sat down with our "checkbook" to see if we were ready to start a family. I mean we missed predicting gas & food $$$ going up this high, among other things.

The real lesson is to not (s)elect arrogant, incompetent kleptocrats like BushCo to run the government, STRS. But since most insurance companies are cut from the same cloth, it's no wonder why our healthcare system is such a mess.

The real lesson is to not (s)elect arrogant, incompetent kleptocrats like BushCo to run the government, STRS. But since most insurance companies are cut from the same cloth, it's no wonder why our healthcare system is such a mess.

Problem is both parties receive large amounts of campaign funds from both health insurance companies and large oil companies. Thus unlike the press sound bites we received from the last campaign Democrats have not done anything about health insurance companies or big oil companies. It sounded great in the last campaign but lets hold the Democratic Congress to their campaign promises (same should hold true for Republicans, only used Democrats here because they took over power based on some of these promises).

Ask seniors how they like the Medicare Part D program created by Congress. I am sure many are not too happy considering every year the benefits change and premiums increase. Not real sure much in health care would change for the better if government was more involved in running it.

Someone will have to convince me that the improvement and reduced cost is more than rhetoric.

I don't agree in letting the government control one more thing in our lives but, I do feel that something has to be done. Checking up on the fraud. cases across the board would be a start. Illegal's, disabilities, medical to name a few.

Yeah, the one where we try and HELP other people, not ask, "who can we stick it to!"
BTW, dolly did you have a point? Ever? Any point to any of your posts??? Or just bringing to the table the worst that America has to offer.

We already have national healthcare, it is called Medicaid and Medicare. Who do you think pays for those systems? The money does not just "poof" out of the blue. I am not suggesting that we copy any of the existing national health care systems because Canada, England and other nations have their own problems, but we might as well go national all the way. The overall cost for healthcare would decrease and we would be better able to care for populations that now fall through the cracks. Dolly and Right_Thinker need to educate before the speak because they sound like fools.

right_thinker: The 20-something "Millenial Kids" who don't hold a job (or a decent job), have dragged college out from four to (not done yet and don't know when), live with mommy and daddy, have an iPhone, multiple tattoos and piercings, show up to their favorite bar or music venue nearly every night of the week, drink $3 cans of Red Bull like there's no tomorrow, wear $80 blue jeans and $120 nikes-you mean those uninsured young adults?

There are a few things wrong with what you've said here. First off, we don't live with mommy and daddy. They live in Johnson County. We live here in Lawrence while we're getting our degree in art. Yes, we do have an iPhone. Yes, we have multiple tattoos and piercings, and show up to our favorite bars as much as we can. But drink Red Bull? As if! $1.50 cans of PBR please. We may buy an $80 pair of blue jeans, but that's the only pair of pants we wear. And Nikes, are you kidding me? Unless they're vintage Nikes over 20 years old, we don't go anywhere near Nike.

Interesting though, when we graduate and want to stay in Lawrence, the only jobs we can find are crappy service industry jobs that pay less than $10/hr with no health insurance.

Dollypawpaw: So the government mandates that everyone gets healthcare and I can expect to pay less?

Think about how much your employer takes out of your paycheck to pay for your health insurance? How much more for your family, too? In addition to that, your taxes go towards the government paying for 44% of health care expenditures. Take these following quotes into account:

"When public and private spending are added together, the U.S. spends more per capita than any other nation."

"The CIA World Factbook ranked the United States 41st in the world for lowest infant mortality rate and 45th for highest total life expectancy."

"The U.S. is the only major industrialized nation in the world lacking government-run or subsidized universal health care."

There is no reason we should be #1 in the world in healthcare spending but 45th in life expectancy. Pull your head out of the sand and realize that we as a nation are spending too much on private healthcare.

"We pay alot because there are alot of people not paying for themselves."

False.
Dolly is using the same flawed logic that claims welfare is a HUGE govt. expenditure and a plague on the national soul, when it's actually a tiny govt. expenditure.
Fact: people who don't have healthcare don't go to the doctor because they can't afford it. They end up in the hospital because there is no preventive treatment and their health problems become critical. I guess Dolly would say they deserve to die.
US healthcare is expensive for the same reason we spend so much money on our schools: we LOVE a beauracracy! Americans love overpaid administrators and inefficiency more than anything.
Our system works best when there's a balance between corporate greed and govt. oversight & regulation. Right now corporate greed rules the roost.

There is no reason we should be #1 in the world in healthcare spending but 45th in life expectancy. Pull your head out of the sand and realize that we as a nation are spending too much on private healthcare.

Could some of this have more to do with the lifestyle of Americans versus being a knock on the health care system?

I mean the obesity rates and other lifestyle choices in America may say more about this than health care system. I doubt life expectancy will go up much in this country unless people take better care of themselves (nutrition, exercise, weight loss, etc.). Americans aren't going to start living longer on average because of national health care.

How is national health care going to increase our life expectancy and make us eat better????

You can't make people eat healthy food, drink less alcohol, exercise regularly, etc. You can educate the hell out of people ..... as a matter of fact I'll bet you that most people that are doing these activities know that they are bad for them. Heck I know just like many others that certain eating habits are bad for me .... but choose to eat fast food anyway.

National health care also isn't going to pay for the foods we eat. Is national health care going to subsidize the lower income Americans to be able to buy the more expensive healthy foods?

Education IS the key. People with un-healthy habits are usually poor, and poor people don't go seek healthcare if they can't pay.
National healthcare simply provides access, Bigdog. Access is all that's required.

Hell I have all kinds of access and still ate lunch today at Long John Silver's.

Just like almost every smoker .... they know the stuff is unhealthy and causes cancer. Not trying to argue here but I don't believe there is a shortage of education on healthier lifestyles. And can lower income individuals afford the healthier foods even if they have the knowledge?

Yes! Everyone must pay into the system so a fewer number can benefit. If only the ones who need care are the ones who are paying for it, how could that ever work out? Especially with insurance companies taking something like a 40% cut? What is needed is people who would never benefit from insurance paying into it so the sick ones can benefit from their money. The unfortunate consequence would be creating a mentality with those who don't need it, that they are being ripped off. Then, they may stop taking responsibility for their health, since that is the only way to benefit.

In a way, it's kind of like Lawrence's parks and recreation. Everyone is charged for the benefits of the swimming pool. I may not use the pool, but you may. Likewise, I may use the tennis courts and you may not. We all pay so we all can enjoy. Taking this a step further, why not you pay to use the pool, and I use the tennis courts. Wouldn't that come out the same? But, what if the pool costs more? I pay part of your pool use, and you pay part of my tennis use. I end up paying for recreation at a higher cost than what I actually use. You gain a greater benefit than the cost of what you actually use. Everyone pays for the "benefit of the community". But, is it fair?

Take it a little further. Even if it could be justified of me paying more for my recreation benefit than you do, would it pay for itself? No. It only works when couch-potato Bill pays for both of our benefits but doesn't make use of either one. There is more than the pool and tennis courts, just like there are more than one couch-potato. It only works, when there are more people who don't use it to pay for those who do. Otherwise, why not let each pay for their own use?

Same with health [sick] insurance. If everyone mismanaged their health to the point of needing heart surgery, then the isurance industry would bankrupt.

Healthy people need to quit subsidizing the sick people who refuse to take responsibility for their health. They need to find an alternative that serves as it was originally imagined (probably a utopia idea, though). Everyone shares when an unexpected disaster happens to someone. And not to subsidize eating fast food and other poor eating habits (including school cafeteria junk food).

From a health care workers perspective, I do get tired of seeing people who don't work and receive medicaid. Young people that have no excuse for not working. They are not disabled, just lazy. Yet with their medicaid cards they do have access to healthcare. Yet the person that works 40+ hours a week, can't afford to go to the doctor. And the families with several young children. Medicaid cards all around. And you can bet the prenatal care and maternity care were all covered by medicaid as well. It's really sickening (pardon the pun), when you see it first hand.

Pharmaceutical companies, most physicians and especially insurance companies are all against any form of nationalized health care, I wonder why? Free enterprise system doesn't work when government protects the monopoly. Health care is not a luxury but necessity!
Dolly, I'm not paying for your facelift operation.

As both a Canadian and a U.S. citizen I've experienced both versions of health care. In my heart I believe that a nationalized health care system is right, but I also think it makes financial sense. National health care systems lower cost per person by having so many people partipate. Furthermore, when the government provides health care, it has an interest in brokering with pharmaceutical companies to keep costs down. That incentive does not exist with no national system and massive campaign contributions from those same companies.

Furthermore, in most countries with a nationalized system, the government also has an incentive to educate (and sometimes propagandize) good health patterns, in school, on billboards and on television/radio. There is a reason Canadian cigarettes have full-color images of cancerous tumors, blackened lungs, coughing fetuses, etc on the packages. The idea that people would "mismanage" their health is ridiculous - regardless of who is paying, you have personal incentive to avoid heart surgery! That being said, your children will be less likely to be obese because they've had good eating hammered into them since preschool.

But frankly, I think that SettingTheRecordStraight is right. This government does nothing but steal our money to fund inefficient and often hair-brained ideas. Politicians look out for the interests of their campaign contributors rather than the interests voters, so any health care system would doubtless be as much of a "quagmire" as just about everything else the government does. Among such quagmires are Iraq, FEMA and the rest of the Dept of Homeland Security, the tax system, the budget, subsidization, the education system and Social Security.

I already pay too much in taxes as a middle class citizen. If the government shows me it can do something right for a change, then maybe I would support it spending more of my money for me.

I'm not understanding why it is such a terrible idea to some people to create a national health care plan. Believe me, I do believe it has a long way to go before it would be effective, but taking care of one's own doesn't always work. While my thinking might be slightly radical for many on this forum, I'll spout my opinion for a bit anyway...... Nationalize health care, but limit those who reap the benefits to those who are under the age of 18, are physically or mentally unable to work, those at retirement age, or are employed full time. If a couple has a child, let one parent drop back to part time and still be able to be covered until the child can fend for themselves after school hours. And while we're at it, why not develop some sort of "reward" (for lack of a better word) for adults who choose to adopt or not procreate? After all, over population is a global epidemic (or is it pandemic?) What it all comes down to is REWARD those who contribute positively to the greater good, SCREW those who don't.

While this plan requires much fine tuning,I believe the main reason why nationalized health care is such a big debate is because you have the self-righteous-self-centered-elitist jerks who can take care of their family due in part to lucky fortune, and the lazy-social-program-abusing who can't take care of themselves, much less a family, because they "have more important things to do". (READ: They have NO excuse.) At any rate, there is a majority of the population stuck in the middle who need nationalized health care. Some of them want it, some of them don't. It's my (very humble) opinion that those who don't are either ill informed or brainwashed. Take your pick.

Another thing that is not fair, is the difference in costs that the insured pay vs the uninsured (they are called self pay). The physicians and other providers contract with the various insurance companies. At that point, the insured individual will pay less than the uninsured individual for the same service. It seems like the cost should be the same regardless. I also think that there should be some type of price list for basic services. How much basic services cost. X amount for routine lab work. X amount for diagnostic tests. Then the patient/consumer could take that into consideration when making decisions regarding their health. The consumer usually has no clue what charges are involved.

Can't have a price list as they have different price lists for different insurance companies. When it comes to self pay, they usually can't tell you what it will cost because they have to look you up and down then decide how much they figure they can sock it to you. Not all are that way, but some. They want to keep you in the dark, and if you ask how much something costs, they look at you weird. It's almost like they are thinking, 'well, what does it matter, aren't you going to do it no matter what it costs?' Answer: No.

Do a test and have two people go in for the same treatment - one with and one without insurance. You may very well find that the one with insurance has a lower cost listed, even if the insurance company doesn't pay all of it, than the one without insurance.

The problem is even with health insurance, it still costs out of pocket. Copays, deductibles, etc. etc. Then after you have met your yearly deductible, insurance is usually 80/20. So you still will be paying 20%. On top of your premiums it can run into the thousands out of pocket. That is where they get you. I think an ambulance ride in Lawrence runs around $500. A lot of policies don't cover all of that. Air transfers start around $7000. That is from Lawrence to a KC hospital. Ridiculous prices for all medical services.

Nationalized Health Care should be an insurance program to be paid for by all citizens so the private insurance company can be eliminated for making big profit, for selecting participants; so the pharmaceutical companies can not sell the same drugs higher than they sell them overseas.

You pay tax for government to build highway, defense forces, schools... don't you? Or you just provide those things for yourself. What will we (regular citizen) do if the gas costs $100 a gallon, food costs $1,000 a week and house costs $10,000 to rent...? Will you still provide them for yourself? Oh yeah, you drive a Rolls Royce, eat caviar and live in a mansion still but how about the rest of us? Revolution?